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Promoting and Improving the Health of Ohio Seniors: The Healthy Town Program


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Title: Promoting and Improving the Health of Ohio Seniors: The Healthy Town Program

Promoting and Improving the Health of Ohio
Seniors The Healthy Town Program
Statewide Expansion Conference/Training
  • Sheila A. Niles, MSN, RN, CS
  • Visiting Nurse Association Healthcare Partners of
  • Sonia Alemagno, PhD
  • Institute for Health and Social Policy
  • University of Akron
  • Project Team

HEALTHY TOWN- SENIORS Acknowledgements
The University of Akron Director, Institute for
Health and Social Policy Sonia Alemagno,
PhD STAFF Anna Copeland Michael Gill,
AAB Rachel Hammel, BA Bradley Perolis,
AAB Peggy Shaffer-King, MA Melissa Smith,
MBA David Veits , AAB
Visiting Nurse Association Healthcare Partners of
Ohio Director, Sheila A. Niles, MSN, RN,
CS STAFF Leo Aukerman, CPA Michelle Soukup,
BA Christine Stevens, BSN, RN Aeron (Sam)
Warren Marilyn Weitzel, PhD, RN
Community Partners Area Agencies on
Aging Cleveland Public Library
Funding Support
  • Administration on Aging
  • Centers for Disease Control
  • Ohio Department of Aging
  • Local/Regional Foundations

Thank you!
Congressman Ralph Regula Ohios 16th
District Federal Appropriations Support
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  • Define health promotion, wellness, and population
  • Discuss the health promotion framework of the
    Healthy Town model and statewide expansion.
  • Demonstrate the Healthy Town technology
  • Discuss program outcomes and sustainability.
  • Describe the senior experience using multiple
    technology programs.

  • Describe the Area Agencies on Aging experience
    using the Healthy Town outcomes.
  • Discuss barriers/strategies to recruit seniors
  • How to use the online technical support page.
  • Explore the Healthy Town WEB site.
  • Evaluation.

  • Setting the Stage

Historical Perspective Health Promotion
  • Process of enabling people to increase control
    over, and to improve their health.

    WHO, 1986
  • The art and science of helping people improve
    their lifestyle to achieve optimal health. The
    most effective programs include education,
    lifestyle change and creating supportive

    Journal of Health Promotion, 1989

  • Preventive illnesses constitute 70 of health
    care costs.
  • Healthy People, 2000, 2010
  • HP/DP for seniors improves clinical outcomes and
    reduces costs.

  • Major causes of morbidity, chronic diseases are
    responsive to prevention and disease
  • It is never too late to improve health through
    preventive approaches and better self-care.

  • Wellness - optimizing health physical, social,
    emotional, intellectual.
  • Personal responsibility and awareness
  • Health Promotion - process that seeks to
    promote wellness by strengthening the
    individuals ability to control his or her own

As seniors live longer, they express a strong
desire to maintain their independence and avoid
functional dependency -
  • Health promotion…necessary, not just nice
  • Jessie C. Gruman, PhD
  • Confronting Ageism and Economics in Promoting
    Elder Health. American Geriatric Society,
    November 23, 2004

  • Seniors value health promotion.
  • Seniors will change their behavior.
  • Health promotion can improve outcomes.
  • Health promotion is cost effective and saves
    health care dollars.

Seniors and the Internet If we build it, they
will come.
  • Demographics Survey of older adults 50
  • Internet is leading source of health information
    for people
  • 50 64 years of age.
  • 19 of seniors who look up health information on
    line indicated they checked the source.
  • Men (38) are more likely to access the internet
    than women (25).
  • People over the age of 60 represent the fastest
    growing group of computer users and information
    seekers on the web.
  • (SourceKaiser Family Foundation

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HEALTHY TOWN Health Promotion Program
  • Health Belief Model
  • Becker, MH, 1974
  • Age specific health domains
  • US Preventive Services Task Force, 1986
  • Healthy People 2000, 2010
  • Health Objectives
    for the Nation

Healthy Town
  • Technology supported health promotion services.
  • Identifies health risk issues.
  • Refers and links to existing resources.
  • Provides standardized population health
    information for program planning and funding
    (Area Agencies on Aging).
  • 2003 Best Practice Award in Health Promotion
  • National Council on Aging

Healthy Town Technology Programs
  • Health Promotion Services
  • Seniors
  • Families with Children
  • Medication Education
  • Learn About Your Medications
  • Healthy Town WEB Site

Healthy Town Technology
  • Laptop and online screenings - Talking
  • Collects information/personalized prevention
    checklist for each senior.
  • Produces aggregate Senior Health Profile.
  • Receives high marks from seniors.

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Health Screening Domains
  • Prevention Needs
  • Mental Health Risk
  • Fall Risk
  • Immunization Risk
  • Nutritional Risk
  • Chronic/Disabling Conditions
  • Medication Risk
  • Technology Demonstration

  • Technology Demonstration

Healthy Town Outcomes
  • Initial pilot (n230 seniors)
  • 58 seniors reached self-selected goals within 2
  • 92 seniors reached second goal within 6 months.
  • CARING Magazine, 1997

Healthy Town Outcomes
  • To date
  • 4,500 Northeast Ohio seniors screened and guided
    to take HP/DP actions.

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Healthy Town Outcomes
  • Regional, State
  • Aggregate profiles guide education programs.
  • Regional AAAs use standardized data for policy
    and program funding.
  • Field training sites for health/social service
  • Statewide expansion via Area Agencies on Aging.
  • Internet access

Ohio Statewide Expansion Sites
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  • What the Seniors say…

Congressman Ralph Regula
I am very enthusiastic about the opportunity to
assist seniors in the 16th congressional district
through the VNA Healthy Town program.
Healthy Town What the Seniors say
  • Very important, makes people aware.
  • Everyone should do it. Good program.
  • Appreciated it did not cost anything.
  • Good information for seniors. We need this!

Healthy Town Senior Experience
  • Excellent program.
  • It was interesting. It gets a person thinking
    about their health.
  • Really great program. Keeps you on your toes.
  • Worthwhile program to get feedback on your
  • Made me more aware.

  • What the AAAs say…

  • Susan H. Schwarzwald
  • Director for Planning and Program
  • Western Reserve Area Agency on Aging
  • The Comprehensive Health Profile (CHP) was used
    as a focus for strategic planning.
  • Our medication risk program (Learn About Your
    Medications) was developed as a response to
    Healthy Town results.
  • The Healthy Town data showed that there was a
    large risk for falls in our population. We asked
    the Cuyahoga County Board of Health to develop a
    fall prevention education program.
  • Healthy Town data was used to determine where
    and how to allocate dollars resources.

  • Kirk Davis
  • Planning and QI Division Director
  • Area Agency on Aging 10B, Inc.
  • We arranged speakers to visit centers to address
    HP/DP issues that were indicated by Healthy Town
  • The Comprehensive Health Profile (CHP) provided
    direction about the health trends for clients.
    This will determine future programming.
  • The CHP was helpful in that it provided
    snapshots of different areas with different
    incomes, city vs. rural, and types of health
    issues they face.

  • Diane Ramey
  • Community Services Director
  • Ohio District 5 Area Agency on Aging, Inc.
  • We are using the Healthy Town Comprehensive
    Health Profile (CHP) to encourage and support
    healthy aging programs and services with our
    planning and service area (PSA 5).
  • We cited Healthy Town data in our grant

  • What the Senior Center Staff say…

  • Edie Appel,
  • Director, Oakwood Golden Age Center
  • Healthy Town is a different kind of program. I
    dont know if you can measure what the seniors
    get out of it but it makes them feel they are
    connected to the world in a way they arent used
    to. They hear about the World Wide Web and this
    gets them out there.
  • My seniors
  • Got an ego boost because they were able to do the
    program on the computer.
  • Enjoyed the connection to the Internet.
  • Used the feedback, read it and acted on it.

  • Edie Appel,
  • Director, Oakwood Golden Age Center
  • Seniors do listen and take action when it is
    their choice.
  • By taking the Healthy Town screening, they feel
    they are playing a role in their health rather
    than just going to a doctor and doing the same
    thing theyve done for 100 years.
  • This program helps them to be proactive which
    with this generation is not typical.

  • Nancy Likens, Director
  • Wadsworth Senior Center
  • We used the Healthy Town data to develop the
    Health Wise Café health information and
    screening day. We also used the results when
    applying for a caregiver grant through the
    Administration on Aging.
  • Pat Lachowski, Director
  • Northern Summit Senior Center
  • Our senior center used the Healthy Town data to
    plan nutrition programming, health screenings and
    have used the information in all the grants we
    have written as proof that we need funding.

  • Ellen Willen, Director
  • Kenmore Senior Center
  • We initiated a Falls prevention program and had
    pharmacists speak to our seniors about medication
  • Elsie Riedel, Director
  • Sycamore Senior Center
  • One client complained of depression prior to
    completing the Healthy Town survey. After the
    survey the client went to a psychologist.
    Director reports, This client seems to be much
    better after her visit to the psychologist.

  • Hazel Blankenship, Director
  • Ohio Heartland Community Action
  • Our seniors were excited to work on the
    computers. We used the Comprehensive Health
    Profile (CHP) information in our application for
    the Community Service Block Grant.

  • Delores Lynch Executive Director,
  • Senior Outreach Services
  • Based on the results from the Healthy Town
    Senior Screening, our center focus moved from
    socialization to a health promotion/wellness
    program. There were several issues common to our
    seniors. We acted on the results by initiating
    programs to cope/manage chronic illnesses,
    prevent falls and increase flexibility and
  • Exercise programs are now offered on a daily
  • Art and Music Therapies were expanded.
  • Initiated massage and Reiki modalities.

Hmm… Interesting program…but is this for us?

Will seniors do this??
  • 4500 Seniors did it!

How to get seniors to Healthy Town…
  • Informational bookmarks
  • Distribute in local libraries
  • Senior Centers
  • City/Township utility bills
  • Grocery stores
  • Churches
  • Local senior volunteer groups
  • Local newspapers
  • Public service announcements on radio
  • Collaborative programs Centers, Aging Network

Do seniors have internet access??
  • Home computers
  • Computer classes at community colleges and
    senior centers
  • Libraries

How long does it take??
  • 10 minutes!


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Evaluation Healthy Town WEB Site
  • Participating senior centers were contacted every
    6 months to determine use of the Healthy Town
    website and to provide feedback.
  • 80 of senior centers actively participate in
    obtaining information on the website.
  • 50 of senior centers use the website for
    program development to obtain information and
    suggestions for programming.
  • 50 of senior centers use the website to obtain
    information regarding specific content needs or
    to address the needs of a senior.

Evaluation Healthy Town WEB site
  • Senior centers find it useful to have a
    comprehensive site where they can link to other
    sites such as the American Heart Association,
    Social Security (, American Dental
  • 30 of senior centers download and print
    information for seniors.
  • Senior centers who visit the website look for
    local links and referral sites.

Program Sustainability
  • Statewide expansion
  • Health promotion for statewide model
  • Technology interface
  • Area Agencies on Aging
  • (Cleveland Public

Ensuring Success
  • Award winning model
  • Evidenced based outcomes
  • Collaborating partners
  • Rapid dissemination of the program

  • Online Technical Support Page
  • Go to

Selected References
  • Alemagno, S., Niles, S.A. Treiber, E. (2004)
    Using Computers To Reduce Medication Misuse Of
    Community-based Seniors Results Of A Pilot
    Intervention Program. Geriatric Nursing, 25(5)
  • McCahon, C.P. Niles, S.A., (2003). Information
    technology applications in a community based
    curriculum. In Oermann, M. (Ed.) Annual Review
    of Nursing Education, Vol. 2 New York Springer.
  • Niles, S., Alemagno, S., Stricklin, M.L.,
    (1997) Healthy Talk A telecommunications model
    for health promotion. CARING, XVI(7), 46-50.
  • Gordon, C. Harris, R.A. (1997). Health
    promotion for seniors What is over the horizon?
    Managed care quarterly, 5 (4), 34-42.

Selected References
  • McCahon, C. Niles, S.A., (2000). Vision on
    22nd Street The Cleveland model. In Matteson,
    P.S. (Ed.) Teaching nurses in the neighborhood
    Innovative responses. New York Springer.
  • Stricklin, M.L., Jones, S., Niles, S.A. (2000)
    HomeTalk, Healthy Talk Improving patients
    health status with telephone technology. Home
    Healthcare Nurse. 18(1), 53-62.
  • U.S. Department of Health and Human Services.
    Healthy People 2010. 2nd ed. With understanding
    and improving health and objectives for improving
    health. Washington, DC U.S. Government Printing
    Office, November 2000.
  • U.S. Preventive Services Task Force. Guide to
    clinical preventive services, 2nd ed. Baltimore
    Williams Wilkins, 1996.